An additional measure to consider when describing the value of a certain nutritional pattern is diet sustainability and diversity. Nowadays, the challenge is to prefer and follow the so-called “win-win diets,” which are dietary models built to preserve both human health and planet sustainability (13). This means nutritional patterns with evidence in the prevention and contrast of diet-related non-communicable diseases and with a positive influence on the stability of the earth's system reducing greenhouse-gas emissions, pollution, climate change, freshwater and land consumption, and biodiversity loss (14). Achieving a healthy and sustainable diet relies on preferring vegetable, organic, and minimally processed foods, as well as regional, seasonal, and fair-trade products (15). There is not a single valid green model of the food system in the world, but, in the European scenario, the MD and the NND reflect the principles of sustainable nutrition. As seen above, these nutritional patterns recommend a daily consumption of plant-based foods with a low ecological footprint. In terms of human health, the choice of this kind of products guarantees a greater supply of vitamins and minerals and other “non-nutrient” compounds, such as the fiber, which, in turn, promotes better general well-being (e.g., higher antioxidant activity, cholesterol control, and weight-body maintenance) (16). In terms of planet health, the shift from animal to plant-based foods, such as vegetables, fruits, legumes, and cereals, could reduce the environmental impact in all the different phases of the food supply chain (production, transformation, distribution, preparation, consumption, and waste management) (17). Empathizing local and seasonable products aids the regional economy as well. Considering a projected population growing to about 10 billion by 2050, the transformation of nutritional habits toward more green models is a challenging goal for the single individual, the whole population, and the next generations.

Sustainability goes hand in hand with diet diversity. The definition of diet diversity is “the number of different foods or food groups consumed over a given reference time period.” As a matter of fact, diet diversity means: seasonability, predominant vegetal over animal sources, lower emissions of greenhouse gases, and nutrition positive for the human microbiome. The predilection for plant-based, local, seasonable (and organic) foods helps to preserve the biodiversity of products, the landscapes, and the sea, and maintains the local economy (16).

Early dietary styles may be adopted from the beginning of complementary feeding (CF), a precious period in which essential nutrients must be provided to the infant and healthy dietary patterns should be established. Offering infants seasonal and local foods is a strategy to favor their acceptance and to create a habit of consumption that will last through adolescence and adult life. The recommendations from the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) state that a varied diet since the initial stages of CF should be offered to infants. Exposing infants to foods with different tastes and textures, such as bitter-tasting green vegetables, is preferred (18). Infants have an innate refusal of bitter tastes and a preference for sugar and salty foods. Families may modify these preferences doing the right choices of foods to offer. Parents' attitudes regarding the nutrition of their infants have an important role, too. It is demonstrated that responsive parenting intervention, oriented to promote the self-regulation of children, initiated in early infancy, when compared with a control intervention, results in a reduction in BMI z-scores at an age of 3 years (19).

Complementary feeding is important not only for the child's growth, attitudes, and preferences but also for reorganizing the dietary choices of the whole family. It is the window in which new eating habits may be established, shifting the choices toward more sustainable and diverse foods, avoiding food waste. In the previous article from our group, we proposed two models of a sustainable diet that respects EFSA nutritional recommendations for an infant between 6 and 24 months of age fed breast milk on demand and 2 complimentary feeding meals (15). These models are reported in Figures 1, 2. Besides the macro- and micronutrients composition of plates, the practical advice to develop a sustainable behavior are: (1) prefer foods produced close to home, especially fruits, vegetables, and legumes; (2) choose non-processed foods, without added ingredients; (3) prefer non-packaged meals (15).

For a better understanding of the child's dietary pattern, the role of the parents' dietary pattern has been recently studied in a few reports. A study involving more than 2,500 mother–child pairs in the United States found that total fat intake was similar between maternal and child's diets (20). A survey conducted among 1,640 children identified a strong association between maternal and 3-year-old children's diet (21). Finally, a very recent study conducted in Iran observed inverse associations between mother–child dyad protein dietary intake and the risk of being underweight and wasting in children (22). These data highlight the importance of shared family dietary patterns that should be better explored in the context of the Japanese, the Mediterranean, the New Nordic, and the Mexican traditional cuisine diet models.

In our epoch, the two extremes of malnutrition coexist. Undernutrition and overweight, or obesity, represent both an actual burden to contrast. These two conditions can sometimes affect the same person in life: an individual who is overweight today may have had a nutritional deficit earlier in life, even in the intrauterine life. To provide healthy and sustainable dietary models, as those discussed in this article, an adequate nutritional intake, both regarding quality and quantity, especially when we consider essential nutrients important to preserve health during the life course, should be concurrently considered. This concept must be accounted for, especially in critical windows of life (such windows as infancy or the reproductive age), which are more sensitive to an optimal dietary intake (23).

Dietary patterns include sustainability (for the planet) and health (for the individual). Some dietary patterns coming around the world, particularly, we described the JD, the MD, the NND, and the Mexican Traditional cuisine as effective ways to promote a diverse and sustainable diet. From an evolutionary perspective, we may understand that “evolution-drivers” among dietary patterns exist, since nutrition evolved in different settings (23). Accordingly, foods locally selected through evolution should be the most indicated for local populations, following the season's cycles. On the other hand, the increasing availability of processed or ultra-processed food should not be ignored, and its potential effects both on health and the circular economy in the context of these models deserve new approaches and investigations (24).

This review has the strength to be a summary of dietary patterns that have both health and cultural implications. It highlights the importance of learning how to make conscious choices since infancy. By narrowing all these aspects to the complex system of personalized nutrition and sustainability, we may expect to personalize the same dietary patterns in turn. Food diversity represents the perfect connection between sustainable and personalized nutrition (25). As an example, a study aimed to challenge personalized nutrition within children following the pattern of MD, with a collaboration between Italian groups in Naples and Israel is currently ongoing. Nevertheless, some of the first researchers in the field of personalized nutrition have underlined, that even prediction models are not able to achieve a full prediction (e.g., of the glycemic response) (26) and that many confounders still need to be accounted for (27). Very few nutritional intervention trials have been planned to get long-term observations to derive useful indications. These factors have been recognized as possibly limiting the effects of personalized nutrition. Therefore, genetic heredity comes first, then the epigenetic changes through an evolutionary perspective (with the derived local lifestyle and dietary patterns), and third, the acute responses to acute changes, whose duration is highly debatable.

From a social epidemiological perspective, preserving these cultural inheritances is a way to achieve planetary health for our and future generations. In line with the present and prospective applications of personalized nutrition, future research in social interventions aimed to improve socioeconomic conditions and spread the knowledge regarding how to preserve the planetary health, at a population level, may be a target point in primary prevention.

A healthy and sustainable diet is possible from infancy, but only if all aspects of the individual are concurrently considered. DRVs are important for supporting public health. Healthcare providers should help and encourage families to follow a sustainable diet from the start of CF in their children. The role of shared dietary patterns should be considered within these interventions.

We proposed two models of an ideal diet at 6 and 24 months that take into consideration both the nutritional needs of the child and the ecological footprints (15). Future studies should investigate the reliability and effectiveness of such models in the real life.

VD, AM, and GM drafted the manuscript. VD arranged the references. CA proofread the manuscript. All authors contributed significantly to the article, agreed on the manuscript in its current form, read, and agreed on the published version of the manuscript.

This study was supported by a contribution from the Italian Ministry of Health (IRCCS Grant).

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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